Filariasis is a chronic disease that causes a number of long term problems like, hydrocoele (accumulation of fluid), elephantiasis of the

leg/scrotum, lymphoedema (swelling of subcutaneous tissues) and chyluria (passing of chyle -a turbid white/yellow fluid- in urine). The clinical manifestations of filariasis develop very slowly. The nature and severity of the manifestations differ in persons who belong to endemic areas from those in persons who have recently travelled to such an area. Cause and Pathogenesis Filariasis is caused by filarial worms which are called Wucheria bancrofti ,Brugia malayi, or Brugia timori. Humans are the definitive host. No definite animal reservoir hosts are known Symptoms and Signs The symptoms that occur in persons affected by filariasis are:

Fever with chills, Swelling in the area where the adult worms are present Enlargement of the lymph nodes Recurrent episodes of fever with chills can occur Inflammatory changes develop in the lymphatics and in the lymph nodes. (This is usually associated with fever and local swelling.) The inflammation in the lymphatics spreads to the neighbouring areas and also spreads in a reverse direction. The lymphatics can become thickened and inflamed. The veins in the region can get involved and this results in inflammatory changes in them.

The changes in the lymphatics can involve the upper and the lower extremities. If lymphatic damage leads onto lymphatic obstruction it causes pitting oedema. Thickening of the subcutaneous tissues can progress to hyperplasia and ultimately to elephantiasis of the involved limb. Infected males develop disease in the scrotum which may cause hydrocoele which in advanced stages may leads to elephantiasis of the scrotum.

Investigations and Diagnosis Diagnosis can be made only by detection of the parasites. Microfilariae can be found in blood and body fluids. Timing of the blood collection is important and should be done in the night. This is because the microfilariae circulate in the blood only in the night time (based on the nocturnal periodicity of the

microfilariae). Elevated eosinophil count in the peripheral blood supports the diagnosis. Other tests not commonly done are, assays for antigens of W. bancrofti and polymerase chain reaction based assays for DNA. Ultrasonogram of the scrotum may help to detect extent of involvement. Cellulitis is a spreading bacterial infection of the skin and the tissues immediately beneath the skin.

Redness, pain, and tenderness are felt over an area of skin, and some people have a fever, chills, and other more serious symptoms. Antibiotics are needed to treat the infection.

Cellulitis may be caused by many different bacteria. The most common are those of the Streptococcus species. Streptococci spread rapidly in the skin because they produce enzymes that hinder the ability of the tissue to confine the infection. Staphylococcus bacteria can also cause cellulitis, as can many other bacteria, especially after bites by humans or animals or after injuries in water or dirt. Bacteria usually enter through small breaks in the epidermis that result from scrapes, punctures, burns, and skin disorders. Areas of the skin that become swollen with fluid (edema) are especially vulnerable. Cellulitis is more common in people with poor blood circulation (chronic venous insufficiency). However, cellulitis can also occur in skin that is not obviously injured. Symptoms Cellulitis most commonly develops on the legs but may occur anywhere. The first symptoms are redness, pain, and tenderness over an area of skin. These symptoms are caused both by the bacteria themselves and by the body's attempts to fight the infection. The infected skin becomes hot and swollen and may look slightly pitted, like an orange peel. Fluid-filled blisters, which may be small (vesicles) or large (bullae), sometimes appear on the infected skin. The borders of the affected area are not distinct, except in a form of cellulitis called erysipelas. Most people with cellulitis feel only mildly ill, but some may have a fever, chills, rapid heart rate, headache, low blood pressure, and confusion. As the infection spreads, nearby lymph nodes may become enlarged and tender (lymphadenitis), and the lymphatic vessels may become inflamed (lymphangitis see Bacterial Skin Infections: Lymphangitis). Sometimes, bacteria spread through the blood (bacteremiasee Bacteremia, Sepsis, and Septic Shock: Bacteremia), which can cause more serious illness.

When cellulitis affects the same site repeatedly, especially the leg, lymphatic vessels may be damaged, causing permanent swelling of the affected tissue. Diagnosis and Treatment A doctor usually diagnoses cellulitis based on its appearance and symptoms. Laboratory identification of the bacteria from blood, pus, or tissue specimens usually is not necessary unless a person is seriously ill or the infection is not responding to drug therapy. Sometimes, doctors need to perform tests to differentiate cellulitis from a blood clot in the deep veins of the leg (deep vein thrombosissee Venous Disorders: Deep Vein Thrombosis (DVT)), because the symptoms of these disorders are similar. A venereal disease is any disease that can be transmitted through sexual contact. These ailments come in a number of forms. Many of them are dermatological in nature, primarily coming with dermatological conditions. A number of them resemble other skin ailments, such as herpes, which is roughly the same as the common chicken pox so many suffer from in their childhoods. Venereal diseases come in many forms, but they are all humiliating. Many do not wish to address them with their doctors, or other medical professionals for this reason Venereal diseases are caused by the spread of infection through sexual intercourse and other forms of fluid contact. Breastfed children and individuals that share unsterilized needles may also contract venereal diseases even without sexual contact. Discharge: Unusual discharge from penis or vagina is the most easily detectable symptom of venereal disease. Infectious genital discharge is usually thick and has an unpleasant odor. Genital discharge is common in most women. However, if there is a sudden change in the color or thickness of the discharge, then it must be considered a venereal disease symptom in women. Pain: Pain due to a venereal disease can be manifested in a number of ways. This may include pain while urinating or a constant pain or discomfort in the abdomen. In case the disease has taken a serious form then sexual intercourse also becomes painful. Sores or Rashes on Skin: Although genitals is the most common place where skin breaks into rashes, this STD symptom in men and women can affect other parts of the body as well. Sometimes sores on the genitals come and go on their own. However, it is best to consult one's physicians at the first instance of such occurrence as complacency could lead to greater complications. Read more on STD symptoms in women. Fever: Fever is something that occurs in a number of diseases and infections.

Hence this should be treated as a sign of STD if only it occurs with any of the other venereal disease symptoms discussed earlier. Read more on signs that you have an STD. Acquired Immunodeficiency Syndrome (AIDS): HIV/AIDS is a relatively new STD that strikes terror in the hearts of people. It is due to the fact that it is fatal as no cure has still been found for it. It is not characterized by symptoms that are just located to the genitals or affect a few other organs, but HIV/AIDS weakens the immune system due to which an individual is left defenseless to a host of diseases. The initial symptoms are short spells of fever with sore throat. Glands in the neck, groin and armpits swell. As the infection spreads, one frequently suffers from cough, chills, fever, fatigue and gradual weight loss. However, sexual means is not the only way of contracting AIDS. Use of infected needles or transfusion of infected blood can also cause AIDS. Chlamydia: This is a very common venereal disease whose symptoms are visible only after the infection has reached an advanced stage. Both men and women experience pain while urinating and during sexual intercourse. Genital discharge is common. Although in men it is clear and watery, in women the discharge is white and thick. Some men may also suffer from pain in testicles on contracting chlamydia. Genital Herpes: Also known as herpes genitalis, this STD is a highly contagious disease that is caused by the herpes simplex virus (HSV). It commonly affects the skin of genitals and rectum. However, the infection can also spread to throat. The initial symptoms of genital herpes is increased sensitivity or a burning and painful sensation in the skin. Within a week the skin in these places become red and small blisters filled with a clear liquid appear. In addition to these, women experience vaginal discharge and pain during urination. In case of lesions close to the head of the penis, men also have pain during urination. These symptoms may also be accompanied with fever and swelling of lymph nodes in the groin. Gonorrhea: Gonorrhea is caused by a bacteria. Although the infection begins in the genitals in women and urethra in men, it may also spread to other parts of the body through bloodstream. Effects on the reproductive system may give rise to problems related to fertility. Gonorrhea symptoms in women include vaginal discharge, irritation of the outer area of the vagina, bleeding between periods and abdominal pain. Men experience blood in urine, frequent urination, swelling of the glands in groin and the head of the penis turns red. Both men and women complain of a burning, stinging pain while urinating and yellowish genital discharge. Women may also have some blood in their discharge. Cellulitis is a spreading bacterial infection of the skin and the tissues immediately beneath the skin.

Redness, pain, and tenderness are felt over an area of skin, and some people have a fever, chills, and other more serious symptoms. Antibiotics are needed to treat the infection.